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Building a broader spectrum of mental health and addiction services will require a significant focus on supporting primary and community providers to deliver more and different services in community settings for people with mental health and addiction needs, particularly in the ‘middle ground’ (people with mild to moderate and moderate to severe mental health and addiction needs).

One critical component, though not the only one, is the role of primary health care in preventing and responding to mental health and addiction needs.139 We note that ‘primary health care’ is very broadly defined. Primary health care in this report refers to general practice, non-governmental organisations (NGOs), Kaupapa Māori, Pacific and other community agencies that offer front-line services. It also includes pharmacies, midwives, school-based services, Well Child Tamariki Ora, Whānau Ora, telehealth services and others. Our vision of what ‘primary health care’ needs to look like is consistent with the type of system outlined in chapter 3 (section 3.6) – that is, many different providers working together in a joined-up way with people at the centre, in a range of primary and community settings, with strong linkages between social and other support services across sectors.

A transformed primary health care sector will be needed to properly support a comprehensive continuum of integrated services to address mental health and addiction needs. In this chapter, we focus on primary health care services, particularly general practice. Some of the issues relating to the wider NGO sector are outlined in chapter 6.


139  N Kates, B Arroll, E Currie, C Hanlon, L Gask, H Klasen, G Meadows, G Rukundo, N Sunderji, T Ruud and M Williams. 2018. Improving collaboration between primary care and mental health services. World Journal of Biological Psychiatry. https://doi.org/10.1080/15622975.2018.1471218(external link).

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